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FHIR Release 3 (STU)

This page is part of the FHIR Specification (v3.0.2: STU 3). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3 R2

11.5 Resource Medication - Content

Pharmacy Work GroupMaturity Level: 3 Trial UseCompartments: Not linked to any defined compartments

This resource is primarily used for the identification and definition of a medication. It covers the ingredients and the packaging for a medication.

11.5.1 Scope and Usage

Representing medications in the majority of healthcare settings is a matter of identifying an item from a list and then conveying a reference for the item selected either into a patient related resource or to other applications. Additional information about the medication is frequently provided for human verification, but a full representation of the details of composition and efficacy of the medicine is conveyed by referring to drug dictionaries by means of the codes they define. There are some occasions where it is necessary to identify slightly more detail, such as when dispensing a package containing a particular medicine requires identification both of the medicine and the package at once. There are also some occasions (e.g. custom formulations) where the composition of a medicine must be represented. In these cases the ingredients of the medicine have to be specified together with the amount contained, though the medication resource does not provide full details.

The Medication resource allows for medications to be characterized by the form of the drug and the ingredient (or ingredients), as well as how it is packaged. The medication will include the ingredient(s) and their strength(s) and the package can include the amount (for example, number of tablets, volume, etc.) that is contained in a particular container (for example, 100 capsules of Amoxicillin 500mg per bottle).

The medication resource can be used to describe a compounded (aka extemporaneous or magistral) product that is manufactured by the pharmacy at the time of dispensing. In this case there will be multiple ingredients which are typically base chemicals (for example, hydrocortisone powder) and there may be other ingredients that are manufactured products (for example, Glaxal Base).

If medication includes a package, further details about the composition can be provided. A package has a container (vacuum packed box, jar, etc.) and a list of the products or other packages that are in the package.

This resource is referenced by ActivityDefinition, AdverseEvent, CarePlan, Flag, Group, MedicationAdministration, MedicationDispense, MedicationRequest, MedicationStatement, Procedure, SupplyDelivery and SupplyRequest

11.5.2 Resource Content

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication DomainResourceDefinition of a Medication
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... code Σ0..1CodeableConceptCodes that identify this medication
SNOMED CT Medication Codes (Example)
... status Σ0..1codeactive | inactive | entered-in-error
MedicationStatus (Required)
... isBrand Σ0..1booleanTrue if a brand
... isOverTheCounter Σ0..1booleanTrue if medication does not require a prescription
... manufacturer Σ0..1Reference(Organization)Manufacturer of the item
... form 0..1CodeableConceptpowder | tablets | capsule +
SNOMED CT Form Codes (Example)
... ingredient 0..*BackboneElementActive or inactive ingredient
.... item[x] 1..1The product contained
..... itemCodeableConceptCodeableConcept
..... itemReferenceReference(Substance | Medication)
.... isActive 0..1booleanActive ingredient indicator
.... amount 0..1RatioQuantity of ingredient present
... package 0..1BackboneElementDetails about packaged medications
.... container 0..1CodeableConceptE.g. box, vial, blister-pack
MedicationContainer (Example)
.... content 0..*BackboneElementWhat is in the package
..... item[x] 1..1The item in the package
...... itemCodeableConceptCodeableConcept
...... itemReferenceReference(Medication)
..... amount 0..1SimpleQuantityQuantity present in the package
.... batch 0..*BackboneElementIdentifies a single production run
..... lotNumber 0..1stringIdentifier assigned to batch
..... expirationDate 0..1dateTimeWhen batch will expire
... image 0..*AttachmentPicture of the medication

doco Documentation for this format

UML Diagram (Legend)

Medication (DomainResource)A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systemscode : CodeableConcept [0..1] A coded concept that defines the type of a medication (Strength=Example)SNOMED CT Medication ?? A code to indicate if the medication is in active usestatus : code [0..1] A coded concept defining if the medication is in active use (Strength=Required)MedicationStatus! Set to true if the item is attributable to a specific manufacturerisBrand : boolean [0..1]Set to true if the medication can be obtained without an order from a prescriberisOverTheCounter : boolean [0..1]Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication productmanufacturer : Reference [0..1] Organization Describes the form of the item. Powder; tablets; capsuleform : CodeableConcept [0..1] A coded concept defining the form of a medication (Strength=Example)SNOMED CT Form ?? Photo(s) or graphic representation(s) of the medicationimage : Attachment [0..*]IngredientThe actual ingredient - either a substance (simple ingredient) or another medicationitem[x] : Type [1..1] CodeableConcept|Reference(Substance| Medication) Indication of whether thisingredient affectsthe therapeutic action of the drugisActive : boolean [0..1]Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tabletamount : Ratio [0..1]PackageThe kind of container that this package comes ascontainer : CodeableConcept [0..1] A coded concept defining the kind of container a medication package is packaged in (Strength=Example)MedicationContainer?? ContentIdentifies one of the items in the packageitem[x] : Type [1..1] CodeableConcept|Reference(Medication) The amount of the product that is in the packageamount : Quantity(SimpleQuantity) [0..1]BatchThe assigned lot number of a batch of the specified productlotNumber : string [0..1]When this specific batch of product will expireexpirationDate : dateTime [0..1]Identifies a particular constituent of interest in the productingredient[0..*]A set of components that go to make up the described itemcontent[0..*]Information about a group of medication produced or packaged from one production runbatch[0..*]Information that only applies to packages (not products)package[0..1]

XML Template

<Medication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>
 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->
 <isBrand value="[boolean]"/><!-- 0..1 True if a brand -->
 <isOverTheCounter value="[boolean]"/><!-- 0..1 True if medication does not require a prescription -->
 <manufacturer><!-- 0..1 Reference(Organization) Manufacturer of the item --></manufacturer>
 <form><!-- 0..1 CodeableConcept powder | tablets | capsule + --></form>
 <ingredient>  <!-- 0..* Active or inactive ingredient -->
  <item[x]><!-- 1..1 CodeableConcept|Reference(Substance|Medication) The product contained --></item[x]>
  <isActive value="[boolean]"/><!-- 0..1 Active ingredient indicator -->
  <amount><!-- 0..1 Ratio Quantity of ingredient present --></amount>
 </ingredient>
 <package>  <!-- 0..1 Details about packaged medications -->
  <container><!-- 0..1 CodeableConcept E.g. box, vial, blister-pack --></container>
  <content>  <!-- 0..* What is  in the package -->
   <item[x]><!-- 1..1 CodeableConcept|Reference(Medication) The item in the package --></item[x]>
   <amount><!-- 0..1 Quantity(SimpleQuantity) Quantity present in the package --></amount>
  </content>
  <batch>  <!-- 0..* Identifies a single production run -->
   <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
   <expirationDate value="[dateTime]"/><!-- 0..1 When batch will expire -->
  </batch>
 </package>
 <image><!-- 0..* Attachment Picture of the medication --></image>
</Medication>

JSON Template

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Medication;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Medication.code [ CodeableConcept ]; # 0..1 Codes that identify this medication
  fhir:Medication.status [ code ]; # 0..1 active | inactive | entered-in-error
  fhir:Medication.isBrand [ boolean ]; # 0..1 True if a brand
  fhir:Medication.isOverTheCounter [ boolean ]; # 0..1 True if medication does not require a prescription
  fhir:Medication.manufacturer [ Reference(Organization) ]; # 0..1 Manufacturer of the item
  fhir:Medication.form [ CodeableConcept ]; # 0..1 powder | tablets | capsule +
  fhir:Medication.ingredient [ # 0..* Active or inactive ingredient
    # Medication.ingredient.item[x] : 1..1 The product contained. One of these 2
      fhir:Medication.ingredient.itemCodeableConcept [ CodeableConcept ]
      fhir:Medication.ingredient.itemReference [ Reference(Substance|Medication) ]
    fhir:Medication.ingredient.isActive [ boolean ]; # 0..1 Active ingredient indicator
    fhir:Medication.ingredient.amount [ Ratio ]; # 0..1 Quantity of ingredient present
  ], ...;
  fhir:Medication.package [ # 0..1 Details about packaged medications
    fhir:Medication.package.container [ CodeableConcept ]; # 0..1 E.g. box, vial, blister-pack
    fhir:Medication.package.content [ # 0..* What is  in the package
      # Medication.package.content.item[x] : 1..1 The item in the package. One of these 2
        fhir:Medication.package.content.itemCodeableConcept [ CodeableConcept ]
        fhir:Medication.package.content.itemReference [ Reference(Medication) ]
      fhir:Medication.package.content.amount [ Quantity(SimpleQuantity) ]; # 0..1 Quantity present in the package
    ], ...;
    fhir:Medication.package.batch [ # 0..* Identifies a single production run
      fhir:Medication.package.batch.lotNumber [ string ]; # 0..1 Identifier assigned to batch
      fhir:Medication.package.batch.expirationDate [ dateTime ]; # 0..1 When batch will expire
    ], ...;
  ];
  fhir:Medication.image [ Attachment ], ... ; # 0..* Picture of the medication
]

Changes since DSTU2

Medication
Medication.status
  • Added Element
Medication.isOverTheCounter
  • Added Element
Medication.form
  • Added Element
Medication.ingredient
  • Added Element
Medication.ingredient.item[x]
  • Added Element
Medication.ingredient.isActive
  • Added Element
Medication.ingredient.amount
  • Added Element
Medication.package.content.item[x]
  • Renamed from item to item[x]
  • Add CodeableConcept
Medication.package.batch
  • Added Element
Medication.package.batch.lotNumber
  • Added Element
Medication.package.batch.expirationDate
  • Added Element
Medication.image
  • Added Element
Medication.product
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 23 tests that all execute ok. 16 fail round-trip testing and 1 r3 resources are invalid (1 errors).).

Structure

NameFlagsCard.TypeDescription & Constraintsdoco
.. Medication DomainResourceDefinition of a Medication
Elements defined in Ancestors: id, meta, implicitRules, language, text, contained, extension, modifierExtension
... code Σ0..1CodeableConceptCodes that identify this medication
SNOMED CT Medication Codes (Example)
... status Σ0..1codeactive | inactive | entered-in-error
MedicationStatus (Required)
... isBrand Σ0..1booleanTrue if a brand
... isOverTheCounter Σ0..1booleanTrue if medication does not require a prescription
... manufacturer Σ0..1Reference(Organization)Manufacturer of the item
... form 0..1CodeableConceptpowder | tablets | capsule +
SNOMED CT Form Codes (Example)
... ingredient 0..*BackboneElementActive or inactive ingredient
.... item[x] 1..1The product contained
..... itemCodeableConceptCodeableConcept
..... itemReferenceReference(Substance | Medication)
.... isActive 0..1booleanActive ingredient indicator
.... amount 0..1RatioQuantity of ingredient present
... package 0..1BackboneElementDetails about packaged medications
.... container 0..1CodeableConceptE.g. box, vial, blister-pack
MedicationContainer (Example)
.... content 0..*BackboneElementWhat is in the package
..... item[x] 1..1The item in the package
...... itemCodeableConceptCodeableConcept
...... itemReferenceReference(Medication)
..... amount 0..1SimpleQuantityQuantity present in the package
.... batch 0..*BackboneElementIdentifies a single production run
..... lotNumber 0..1stringIdentifier assigned to batch
..... expirationDate 0..1dateTimeWhen batch will expire
... image 0..*AttachmentPicture of the medication

doco Documentation for this format

UML Diagram (Legend)

Medication (DomainResource)A code (or set of codes) that specify this medication, or a textual description if no code is available. Usage note: This could be a standard medication code such as a code from RxNorm, SNOMED CT, IDMP etc. It could also be a national or local formulary code, optionally with translations to other code systemscode : CodeableConcept [0..1] A coded concept that defines the type of a medication (Strength=Example)SNOMED CT Medication ?? A code to indicate if the medication is in active usestatus : code [0..1] A coded concept defining if the medication is in active use (Strength=Required)MedicationStatus! Set to true if the item is attributable to a specific manufacturerisBrand : boolean [0..1]Set to true if the medication can be obtained without an order from a prescriberisOverTheCounter : boolean [0..1]Describes the details of the manufacturer of the medication product. This is not intended to represent the distributor of a medication productmanufacturer : Reference [0..1] Organization Describes the form of the item. Powder; tablets; capsuleform : CodeableConcept [0..1] A coded concept defining the form of a medication (Strength=Example)SNOMED CT Form ?? Photo(s) or graphic representation(s) of the medicationimage : Attachment [0..*]IngredientThe actual ingredient - either a substance (simple ingredient) or another medicationitem[x] : Type [1..1] CodeableConcept|Reference(Substance| Medication) Indication of whether thisingredient affectsthe therapeutic action of the drugisActive : boolean [0..1]Specifies how many (or how much) of the items there are in this Medication. For example, 250 mg per tablet. This is expressed as a ratio where the numerator is 250mg and the denominator is 1 tabletamount : Ratio [0..1]PackageThe kind of container that this package comes ascontainer : CodeableConcept [0..1] A coded concept defining the kind of container a medication package is packaged in (Strength=Example)MedicationContainer?? ContentIdentifies one of the items in the packageitem[x] : Type [1..1] CodeableConcept|Reference(Medication) The amount of the product that is in the packageamount : Quantity(SimpleQuantity) [0..1]BatchThe assigned lot number of a batch of the specified productlotNumber : string [0..1]When this specific batch of product will expireexpirationDate : dateTime [0..1]Identifies a particular constituent of interest in the productingredient[0..*]A set of components that go to make up the described itemcontent[0..*]Information about a group of medication produced or packaged from one production runbatch[0..*]Information that only applies to packages (not products)package[0..1]

XML Template

<Medication xmlns="http://hl7.org/fhir"> doco
 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <code><!-- 0..1 CodeableConcept Codes that identify this medication --></code>
 <status value="[code]"/><!-- 0..1 active | inactive | entered-in-error -->
 <isBrand value="[boolean]"/><!-- 0..1 True if a brand -->
 <isOverTheCounter value="[boolean]"/><!-- 0..1 True if medication does not require a prescription -->
 <manufacturer><!-- 0..1 Reference(Organization) Manufacturer of the item --></manufacturer>
 <form><!-- 0..1 CodeableConcept powder | tablets | capsule + --></form>
 <ingredient>  <!-- 0..* Active or inactive ingredient -->
  <item[x]><!-- 1..1 CodeableConcept|Reference(Substance|Medication) The product contained --></item[x]>
  <isActive value="[boolean]"/><!-- 0..1 Active ingredient indicator -->
  <amount><!-- 0..1 Ratio Quantity of ingredient present --></amount>
 </ingredient>
 <package>  <!-- 0..1 Details about packaged medications -->
  <container><!-- 0..1 CodeableConcept E.g. box, vial, blister-pack --></container>
  <content>  <!-- 0..* What is  in the package -->
   <item[x]><!-- 1..1 CodeableConcept|Reference(Medication) The item in the package --></item[x]>
   <amount><!-- 0..1 Quantity(SimpleQuantity) Quantity present in the package --></amount>
  </content>
  <batch>  <!-- 0..* Identifies a single production run -->
   <lotNumber value="[string]"/><!-- 0..1 Identifier assigned to batch -->
   <expirationDate value="[dateTime]"/><!-- 0..1 When batch will expire -->
  </batch>
 </package>
 <image><!-- 0..* Attachment Picture of the medication --></image>
</Medication>

JSON Template

Turtle Template

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:Medication;
  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:Medication.code [ CodeableConcept ]; # 0..1 Codes that identify this medication
  fhir:Medication.status [ code ]; # 0..1 active | inactive | entered-in-error
  fhir:Medication.isBrand [ boolean ]; # 0..1 True if a brand
  fhir:Medication.isOverTheCounter [ boolean ]; # 0..1 True if medication does not require a prescription
  fhir:Medication.manufacturer [ Reference(Organization) ]; # 0..1 Manufacturer of the item
  fhir:Medication.form [ CodeableConcept ]; # 0..1 powder | tablets | capsule +
  fhir:Medication.ingredient [ # 0..* Active or inactive ingredient
    # Medication.ingredient.item[x] : 1..1 The product contained. One of these 2
      fhir:Medication.ingredient.itemCodeableConcept [ CodeableConcept ]
      fhir:Medication.ingredient.itemReference [ Reference(Substance|Medication) ]
    fhir:Medication.ingredient.isActive [ boolean ]; # 0..1 Active ingredient indicator
    fhir:Medication.ingredient.amount [ Ratio ]; # 0..1 Quantity of ingredient present
  ], ...;
  fhir:Medication.package [ # 0..1 Details about packaged medications
    fhir:Medication.package.container [ CodeableConcept ]; # 0..1 E.g. box, vial, blister-pack
    fhir:Medication.package.content [ # 0..* What is  in the package
      # Medication.package.content.item[x] : 1..1 The item in the package. One of these 2
        fhir:Medication.package.content.itemCodeableConcept [ CodeableConcept ]
        fhir:Medication.package.content.itemReference [ Reference(Medication) ]
      fhir:Medication.package.content.amount [ Quantity(SimpleQuantity) ]; # 0..1 Quantity present in the package
    ], ...;
    fhir:Medication.package.batch [ # 0..* Identifies a single production run
      fhir:Medication.package.batch.lotNumber [ string ]; # 0..1 Identifier assigned to batch
      fhir:Medication.package.batch.expirationDate [ dateTime ]; # 0..1 When batch will expire
    ], ...;
  ];
  fhir:Medication.image [ Attachment ], ... ; # 0..* Picture of the medication
]

Changes since DSTU2

Medication
Medication.status
  • Added Element
Medication.isOverTheCounter
  • Added Element
Medication.form
  • Added Element
Medication.ingredient
  • Added Element
Medication.ingredient.item[x]
  • Added Element
Medication.ingredient.isActive
  • Added Element
Medication.ingredient.amount
  • Added Element
Medication.package.content.item[x]
  • Renamed from item to item[x]
  • Add CodeableConcept
Medication.package.batch
  • Added Element
Medication.package.batch.lotNumber
  • Added Element
Medication.package.batch.expirationDate
  • Added Element
Medication.image
  • Added Element
Medication.product
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON.

See R2 <--> R3 Conversion Maps (status = 23 tests that all execute ok. 16 fail round-trip testing and 1 r3 resources are invalid (1 errors).).

 

Alternate definitions: Master Definition (XML, JSON), XML Schema/Schematron (for ) + JSON Schema, ShEx (for Turtle)

11.5.2.1 Terminology Bindings

PathDefinitionTypeReference
Medication.code A coded concept that defines the type of a medicationExampleSNOMED CT Medication Codes
Medication.status A coded concept defining if the medication is in active useRequiredMedicationStatus
Medication.form A coded concept defining the form of a medicationExampleSNOMED CT Form Codes
Medication.package.container A coded concept defining the kind of container a medication package is packaged inExampleMedicationContainer

11.5.3 Best practices for using 'Medication'

Medication does not have a status. Pharmacy is evaluating formulary use cases. Feedback is encouraged to the Pharmacy working group committee.

11.5.4 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

NameTypeDescriptionExpressionIn Common
codetokenCodes that identify this medicationMedication.code4 Resources
containertokenE.g. box, vial, blister-packMedication.package.container
formtokenpowder | tablets | capsule +Medication.form
ingredientreferenceThe product containedMedication.ingredient.item.as(Reference)
(Medication, Substance)
ingredient-codetokenThe product containedMedication.ingredient.item.as(CodeableConcept)
manufacturerreferenceManufacturer of the itemMedication.manufacturer
(Organization)
over-the-countertokenTrue if medication does not require a prescriptionMedication.isOverTheCounter
package-itemreferenceThe item in the packageMedication.package.content.item.as(Reference)
(Medication)
package-item-codetokenThe item in the packageMedication.package.content.item.as(CodeableConcept)
statustokenactive | inactive | entered-in-errorMedication.status